Azithromycin, a macrolide antibiotic, disrupts bacterial protein synthesis by binding to the 50S ribosomal subunit. This binding inhibits transpeptidation, crucial for peptide bond formation during protein synthesis. Additionally, Azithromycin 500 mg interferes with ribosomal translocation along mRNA, halting the elongation of the protein chain. Its selective toxicity targets bacterial ribosomes while sparing eukaryotic counterparts, minimizing host cell damage. Azithromycin’s post-antibiotic effect further prolongs bacterial growth inhibition even after drug elimination. While effective against various bacterial infections, prudent use is necessary to prevent antibiotic resistance. Awareness of potential side effects is crucial for safe administration.